Effects of Combining Shockwaves or Radiofrequency with Aerobic Exercise on Subcutaneous Adipose Tissue and Lipid Mobilization: A Randomized Controlled Trial

Reducing abdominal subcutaneous fat is a common concern among women, with evidence suggesting that combining aerobic exercise with external shock waves or radiofrequency may enhance fat reduction. This study aimed to assess the effects of six sessions of external shock wave therapy or radiofrequency combined with an aerobic exercise program on abdominal subcutaneous fat and lipid mobilization, compared to the effects of an aerobic exercise program alone. Thirty-one women (aged 18–60) were randomly assigned to three groups: EG1 (shockwave therapy + aerobic exercise), EG2 (radiofrequency + aerobic exercise), and CG (aerobic exercise only). Body composition measures, mean temperature, adipose tissue thickness, lipid profile, and glycerol and interleukin-6 levels were assessed before and after intervention. A significant decrease in the EG groups compared to the CG was observed in the subcutaneous abdominal thickness (p < 0.001, effect size of η2p = 0.446) and waist–hip ratio (p ≤ 0.001, effect size of η2p = 0.408). No significant changes were verified in the levels of lipolytic activity, lipid profile, and interleukine-6. Six sessions of shockwave or radiofrequency therapy combined with aerobic exercise reduced subcutaneous fat thickness and improved hip–waist ratio more effectively than aerobic exercise alone, without affecting lipid mobilization by changes in lipid profile, lipolytic activity, or interleukin-6 levels.